Information Collection

Screener and Follow-up Scheduling

IC 257457 under ICR 202212-2127-005 · OMB 2127-0764.

Documents and Forms

Document Name Document Type
Form 1687 Screener and Follow-up Scheduling Form and Instruction
1687 Recruitment Telephone Screener Guide PRA_Screener_CPSRideshare_2127-New_093022.docx Form and Instruction
1687 Recruitment Telephone Screener Guide PRA_Screener_CPSRideshare_2127-New_093022.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Screener and Follow-up Scheduling	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1687	Recruitment Telephone Screener Guide	PRA_Screener_CPSRideshare_2127-New_093022.docx		No		Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	1,599	1,599

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.